1. SAMPLE Job Analysis Questionnaire Page 1

Transcription

1 1 SAMPLE Job Analysis Questionnaire Page 1 In completing this analysis, please respond to every section After you and your supervisor complete the questionnaire, the answers will be rated and analyzed Your responses are used to determine the ranking of your position relative to others in the district and aid in the analysis to see if your position is properly classified Your responses, therefore, need to be as complete and accurate as possible They will not be used to evaluate your job nor be seen as limiting the authority of district management to assign work Name: Please answer the following: Department: Location: Phone Number: Length of time in this position: How many months out of the year do you work: Supervisor's Contact Information: Supervisor Name: Supervisor Supervisor Phone: CURRENT JOB FAMILY: If you disagree, please enter the correct job family: CURRENT JOB TITLE: If you disagree, please recommend an appropriate job title: CURRENT DEFINITION: If you disagree, please suggest alternate wording: CURRENT DISTINGUISHING JOB CHARACTERISTICS: If you disagree, please suggest alternate wording: Page 1

2 2 SAMPLE Job Analysis Questionnaire Page 2 INTERACTION WITH OTHERS ON A FREQUENT BASIS If any of the interactions are checked, describe the reason and the frequency of the work contact in the box provided gfedc gfedc gfedc gfedc gfedc gfedc gfedc Students General Public Teachers Administrators Vendors Classified Employees Other (Explain below) Explain your Selections (Be as Detailed as Possible) WRITTEN MATERIALS PRODUCED: Check only those that are produced while performing job related gfedc gfedc gfedc gfedc tes Informal s Reports Other (Explain below) Explain your Selections (Be as Detailed as Possible) Page 2

3 3 SAMPLE Job Analysis Questionnaire Page 3 SUPERVISION RECEIVED Decision Making Authority: Check the closest match gfedc Close Supervision Work frequently checked by supervisor Does not make decisions regarding work assignments gfedc General Supervision Works alone on routine or regular work assignments, checks with the supervisor regarding non routine assignments or when in doubt as to correct procedures to be followed Makes limited decisions on routine assignments Other decisions require supervisory approval gfedc Limited Supervision Requires occasional supervision while working toward a definite objective requiring use of a wide range of procedures Plans, arranges, and/or determines the specific procedures or equipment needs required to meet assigned objectives Analyzes and solves non routine problems, guided by work policies, procedures and manuals, refers only unusual decisions to supervisor gfedc Minimal Supervision Works from broad policies and on general objectives Routinely analyzes, evaluates and solves problems that arise in the course of work, and refers specific matters to superior(s) only when interpretation or clarification of departmental or district policies is necessary gfedc Other (please specify) DIRECT SUPERVISION is defined as budgetary responsibility for the position and accountability to include scheduling, appraisals, goal setting, and disciplinary action Based on the definition above, do you directly supervise full time or part time staff? (Students are not included) YES NO If, how many employees do you supervise?: If, identify staff name, job title and full or part time status below: (Example: Jean Doe, Office Assistant I/ PT) LEAD RESPONSIBILITIES is defined as scheduling staff, providing daily work assignments and recommendations regarding goals or evaluations Based on the definition above, do you lead full time or part time staff? (Students are not included) YES NO Page 3

4 If, how many employees do you have lead responsibilities over?: If, identify staff name, job title and full or part time status below: (Example: Jean Doe, Office Assistant I/ PT) Page 4

5 4 SAMPLE Questionnaire Task Worksheet Please review the following statements These are the duties listed in the current job description Rate them accordingly Relative Time Spent Schedule from Percentage of Time Table: ~FREQUENTLY: Performs task Daily or Weekly ~OCCASIONALLY: Performs task Monthly or Quarterly ~RARELY: Performs task Annuy ~NOT PERFORMED: Task is no longer performed Task 1 RARELY in comparison to other job OCCASIONALLY in Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 2 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 3 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): Page

6 This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 4 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): Page

7 This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 7 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 8 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 9 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): Page 7

12 This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 22 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Page 12

13 SAMPLE Questionnaire Task Worksheet Cont'd Use this portion of the questionnaire to indicate duties currently performed, not listed on the current job description for this position and rate them accordingly Relative Time Spent Schedule from Percentage of Time Table: ~FREQUENTLY: Performs task Daily or Weekly ~OCCASIONALLY: Performs task Monthly or Quarterly ~RARELY: Performs task Annuy ~NOT PERFORMED: Task is no longer performed Task 1 Other Tasks (not currently listed on the job description) RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 2 Other Tasks (not currently listed on the job description) RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 3 Other Tasks (not currently listed on the job description) Page 13

14 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task If the task statement needs to be re worded, please re write it here: Task 4 Other Tasks (not currently listed on the job description) RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task Task Other Tasks (not currently listed on the job description) RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task Task Other Tasks (not currently listed on the job description) Page 14

15 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task Task 7 Other Tasks (not currently listed on the job description) RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task Task 8 Other Tasks (not currently listed on the job description) RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task Task 9 Other Tasks (not currently listed on the job description) Page 1

16 RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task Task 10 Other Tasks (not currently listed on the job description) RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task Task 11 Other Tasks (not currently listed on the job description) RARELY Relative Time Spent Specify percentage of time based on selection made Example: t Applicable or Monthly 2% (Refer to Percentage of Time Table): This task is NOT PERFORMED or and this task is an Task Page 1

17 SAMPLE Questionnaire Education, Training and Experience Requirements Indicate the qualifications and requirements for successful which should be required in filling a future vacancy in your classification Describe what you think is necessary, not necessarily your own qualification Indicate your reasons for selecting these requirements Minimum Formal Education: Specialized Training years and type (If not applicable, please type N/A): Previous Experience (years and type): Licenses, Certification or Registration (If not applicable, please type N/A): Valid Driver s License is required Training Period (required for a new employee possessing the qualifications above): If not applicable, please type N/A Page 17

18 7 Knowledge Rate the knowledge required for the job 1 Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: 2 Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: 3 Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Page 18

19 only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Knowledge NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: 4 Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Page 19

20 NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: 7 Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: Page 20

21 8 Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: 9 Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: 10 Knowledge of NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Page 21

22 NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: Page 22

23 8 Knowledge Cont'd Use this portion of the questionnaire to indicate knowledge which may be required at the time of hire, are NOT currently listed on the current job description for this position and rate them accordingly 1 Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job If the Knowledge statement needs to be re worded, please re write it here: 2 Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job Page 23

24 3 Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job 4 Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Page 24

25 only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Knowledge NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job 7 Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job Page 2

26 8 Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job 9 Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Knowledge only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job 10 Other Knowledge Needed (not currently listed on the job description) NOT REQUIRED AFTER HIRE for successful REQUIRED WHEN HIRED for successful job job When Required Page 2

27 only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Knowledge NO Possession of increasing amounts of this Knowledge better job YES Possession of increasing amounts of this Knowledge better job Page 27

28 9 Skills Rate the skills required for the job 1 Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: 2 Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: 3 Skill to When Required Page 28

29 Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job Skill NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: 4 Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job Page 29

30 NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: 7 Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: Page 30

31 8 Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: 9 Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: 10 Skill to When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job Page 31

32 NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job If the Skill statement needs to be re worded, please re write it here: Page 32

33 10 Skills Cont'd Use this portion of the questionnaire to indicate skills which may be required at the time of hire, are NOT currently listed on the current job description for this position and rate them accordingly 1 Other Skills Needed (not currently listed on the job description) When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job 2 Other Skills Needed (not currently listed on the job description) When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job 3 Other Skills Needed (not currently listed on the job description) Page 33

34 When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job 4 Other Skills Needed (not currently listed on the job description) When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job Other Skills Needed (not currently listed on the job description) When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job Page 34

35 NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job Other Skills Needed (not currently listed on the job description) When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job 7 Other Skills Needed (not currently listed on the job description) When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job 8 Other Skills Needed (not currently listed on the job description) Page 3

36 When Required Skill Possession of this Skill is only Possession of this Skill is Possession of this Skill is HELPFUL or DESIRABLE for RELATED to over satisfactory over satisfactory job job satisfactory job satisfactory job NO Possession of increasing amounts of this Skill beyond YES Possession of increasing amounts of this Skill beyond the minimum level required will not result in better job the minimum level required is likely to result in better job Page 3

37 11 Abilities Rate the abilities required for the job 1 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 2 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 3 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability Page 37

38 NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 4 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: Ability to NOT REQUIRED REQUIRED When Required Page 38

39 only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 7 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 8 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability Page 39

40 NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 9 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 10 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 11 Ability to NOT REQUIRED REQUIRED When Required Page 40

41 only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 12 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 13 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability Page 41

42 NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 14 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: 1 Ability to NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job If the Skill statement needs to be re worded, please re write it here: Page 42

43 12 Abilities Cont'd Use this portion of the questionnaire to indicate abilities which may be required at the time of hire, are NOT currently listed on the current job description for this position and rate them accordingly 1 Other Abilities Needed (not currently listed on the job description) NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job 2 Other Abilities Needed (not currently listed on the job description) NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job 3 Other Abilities Needed (not currently listed on the job description) Page 43

44 NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job 4 Other Abilities Needed (not currently listed on the job description) NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job Other Abilities Needed (not currently listed on the job description) NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability Page 44

45 NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job Other Abilities Needed (not currently listed on the job description) NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job 7 Other Abilities Needed (not currently listed on the job description) NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job 8 Other Abilities Needed (not currently listed on the job description) Page 4

46 NOT REQUIRED REQUIRED When Required only HELPFUL or DESIRABLE for over satisfactory job satisfactory job satisfactory job satisfactory job Ability NO Possession of increasing amounts of this Ability better job YES Possession of increasing amounts of this Ability better job Page 4

47 13 Working Conditions Which May Occur Please respond or to the following statements: Frequently travel to locations other than assigned site If '', Please specify: Works at locations other than assigned site If '', Please specify: Schedule changes may frequently occur based on business needs If '', Please specify: Works where overtime may occur If '', Please specify: May work some weekends If '', Please specify: Works inside protected from weather If '', Please specify: Work outside, not in a building, shop, etc, exposed to the weather If '', Please specify: Page 47

48 Works in an area where a high level of sound occurs If '', Please specify: Work where there is the possibility of direct contact with electrical panels, circuits, or equipment such as power lines, transformers, or hand tools If '', Please specify: Works in areas where there is the possibility of fing or losing one s footing due to slippery, loose or uneven footing If '', Please specify: Works where exposure to direct sunlight on unprotected skin may occur If '', Please specify: Works on or around moving machinery or equipment or near any object that changes position, location or speed This includes stationary machines with moving parts and vehicles in the work area If '', Please specify: Operate a motorized vehicle during work hours as part of the duties of the classification If '', please specify: Works apart from other people, especiy when physicy or visuy isolated from others by structures or distance If '', Please specify: Page 48

49 Works in areas where exposure to insects and spider bites or stings may occur If '', Please specify: Work situations which require the supervision or control of persons who may become physicy violent, or combative If '', Please specify: Tasks performed involve leaning, bending forward, kneeling or squatting several times an hour If '', Please specify: Tasks performed involve working with the wrists in a bent or twisted positions several times an hour If '', Please specify: Are there other working conditions you would like to add? If yes, enter them in the 'Other' box Other (please specify) Page 49

50 14 Examples of physical ability requirements necessary to perform the above jo Does your position require any of the following physical abilities? Please respond or to the listed statements: MUSCULAR TENSION: Muscular effort (or strength) needed to lift, push, pull or carry an object Muscular strength is the capacity of your body's muscles to generate force in a short period of time (< 4 minutes) It does not involve prolonged exertion or fatigue and it is not concerned with the number of times a task is repeated Some terms used when describing this strength are lift, push, pull, carry, and drag If '', Please describe: MUSCULAR POWER: (Explosive Strength) Short rapid burst of energy to propel either the body or an external object This burst of energy usuy takes less than 10 seconds Explosive Strength does not involve the continuous or repeated use of energy Some terms used when describing this strength are swing, throw, jerk, and jump If '', Please describe: MUSCULAR ENDURANCE: (Dynamic Strength) Muscle Endurance is the measure of how well muscles can repeatedly generate force, and the amount of time they can maintain activity Muscular endurance requires strength to resist fatigue Some terms used when describing this strength include repeatedly push, continuously pull, and continuy run Other (please specify) FLEXIBILITY: The ability to bend, stretch, twist, or reach out with the body, arms, and/or legs to perform a task Flexibility can also involve the continuous and repeated bending, stretching or twisting movements of the torso, arms or legs Some terms used to describe this ability are reach, bend, and stretch If '', Please describe: Page 0

51 CARDIO RESPIRATORY ENDURANCE: Requires the heart and lungs to perform efficiently to avoid getting winded or out of breath during periods of prolonged physical exertion This ability involves continuous physical activity that places a strain on the heart and lungs Some terms used in describing this ability are chase, struggle, endure, and sustain If '', Please describe: SPEED OF LIMB MOVEMENT: Speed with which a single rapid movement of the arm or leg is made Strength is not a factor in this ability Some terms used when describing this ability are swing, block, and seize If '', Please describe: WHOLE BODY COORDINATION: Coordinated movements of the arms, legs and torso while the whole body is in motion Some activities that require this ability are climbing, swimming, and crawling If '', Please describe: WHOLE BODY EQUILIBRIUM: Keep balanced and stay upright when in an unstable position Equilibrium is necessary in situations where another force may cause one to begin to lose balance Some that require this ability are stand on the scaffolding, walk in very strong winds, and walk quickly on a slippery surface If '', Please describe: ARM HAND STEADINESS: Precise positioning and movement of the arm and hand This ability involves maintaining precision and steadiness of the arm and hand during movement and holding the arm and hand in a fixed position Some that require this ability are thread a needle, hold a flashlight steady, and move a cutting torch in a steady manner If '', Please describe: Page 1

52 MULTI LIMB COORDINATION: Coordination of two or more limbs (arms and legs) while seated or standing in one place The trunk of the body is not involved in the use of this ability Some that require this ability include operate the hand and foot controls of a forklift, operate a drill press, and drive a car Other (please specify) MANUAL DEXTERITY: Coordinated, precise movement of the hand or hand and arm together These movements are used to grasp, place, move or assemble objects with some degree of quickness Some that require this ability are assemble a part at a work bench, use various hand held tools, and rapidly place objects in a box If '', Please describe: FINGER DEXTERITY: Coordinated, precise movement of the fingers of one or both hands These movements are used to grasp, place or move sm objects with some degree of quickness Some that require this ability include assemble a carburetor at a work bench If '', Please describe: NEAR VISUAL ACUITY: See clearly objects and close surroundings that are 3 inches or closer Some that require this ability are being able to see the wear marks on a machine part or repair a circuit board If '', Please describe: FAR VISUAL ACUITY: See clearly objects and surroundings that are six feet or further away Some that require this ability are seeing other vehicles while driving or seeing approaching cars while flagging If '', Please describe: Page 2

53 COLOR DISCRIMINATION: Tell the difference between shades of one color or the difference between two or more colors This ability includes being able to detect differences in the brightness of colors Some that require this ability are being able to distinguish between a red light and a green light or match paint colors If '', Please describe: PERIPHERAL VISION: Part of vision that occurs outside the very center of gaze owing the individual to see objects, movement or sharp contrasts toward the edges of the visual field Peripheral vision is the ability to see these contrasts and gross movements such as in noticing if a car is coming at you from the extreme right or extreme left as you cross the street facing forward If '', Please describe: SPEECH INTELLIGIBILITY IN QUIET: Hear and understand human speech in a relatively quiet environment Some that require this ability are hear someone speak in a quiet office, at a sm group meeting, or in a quiet library If '', Please describe: SPEECH INTELLIGIBILITY IN NOISE: Hear and understand human speech in a relatively noisy environment Some that require this ability are hear someone speak to you in a car on the freeway with the windows rolled down or near a noisy piece of machinery If '', Please describe: SOUND LOCALIZATION: Tell from what direction a sound is coming from Some that require this ability are hear from what direction someone is cing for help, hear from where an emergency alarm is coming, or locate the source of an air leak in an air line If '', Please describe: Page 3